NPIMap

Individual provider Active NPI

Gershon Bobby Koshy

  • Interventional Cardiology Physician
  • Tulsa, OK
National Provider Identifier
1730686379
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
6691 Issued in OK
Practice address
717 S Houston Ave Ste 400
Tulsa, OK 74127-9007
Phone
(918) 582-7711
Fax
(918) 583-5831
NPI assigned
Apr 10, 2018
Last updated
Jun 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 6691 OK
Interventional Cardiology Physician 207RI0011X 6691 OK Primary

Addresses

Primary practice location

717 S Houston Ave Ste 400
Tulsa, OK 74127-9007

Mailing address

5310 E 31St St Ste 13
Tulsa, OK 74135-5013
Phone (918) 561-5701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250715000062 OK Practitioner - Cardiovascular Disease (Cardiology) 5395250732 Reassigns benefits to 2 organizations
I20250805003490 TX Practitioner - Cardiovascular Disease (Cardiology) 5395250732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Oklahoma State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oklahoma State UniversityGroup PAC ID 2769739358, 110 clinicians
Creek Nation Hospital and ClinicsGroup PAC ID 5698786226, 364 clinicians

Practice addresses (Care Compare)

042 Murray
Stillwater, OK 74078-0001

10109 E 79TH St
Tulsa, OK 74133-4564
Phone (918) 756-4333

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting1-10
Leg revascularization (restoring blood flow)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Oklahoma State University Cardiovascular Disease CurrentSince Jul 1, 2025 Accepting new patients
Oklahoma State University CurrentSince Jul 1, 2025 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 28, 2025 Accepting new patients
Creek Nation Hospital & Clinics Current Accepting new patients
Oklahoma State University Current Accepting new patients
Creek Nation Hospital & Clinics CurrentSince Jul 28, 2025 Accepting new patients
Oklahoma State University Medical Trust Past Accepting new patients

Locations

1101 S Belmont Ave
Ste 204
Okmulgee, OK 74447
Phone (918) 756-3526

1401 Morris Dr
Okmulgee, OK 74447
Phone (918) 456-0641

900 E Airport Rd
Okmulgee, OK 74447
Phone 91875643334448

042 Murray
Stillwater, OK 74078
Phone (405) 744-6021

10109 E 79th St
Tulsa, OK 74133
Phone (888) 552-6760

5310 E 31st St
Ste 13
Tulsa, OK 74135
Phone (918) 561-5701

717 S Houston Ave
Ste 400
Tulsa, OK 74127
Phone (918) 382-4600

Dept 1467
Tulsa, OK 74182

Dept 2563
Tulsa, OK 74182

Interoperability endpoints

  • Direct secure messaging: gkoshy99475@direct.saintfrancis.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1730686379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 E 31ST ST STE 13",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741355013",
            "telephone_number": "918-561-5701",
            "fax_number": "918-561-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S HOUSTON AVE STE 400",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741279007",
            "telephone_number": "918-582-7711",
            "fax_number": "918-583-5831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSHY",
        "first_name": "GERSHON",
        "middle_name": "BOBBY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-10",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OK",
            "license": "6691",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OK",
            "license": "6691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.